ABSTRACT
The authors present 20 microvascular flaps based on arteriovenous perfusion, harvested
from the distal anterior forearm, and configured in three different designs. Indications
were small palmar, dorsal, and commissural defects, when other conventional procedures
were not available; problematic cases of open reduction internal fixation with skin
defect; and when aggressive rehabilitation was needed. The follow-up varied between
6 and 28 months. Some degree of vascular congestion was observed in 100 percent of
the flaps, and those changes were classified in a progressive form. Coverage was judged
as stable, thin, and pliable in 75 percent of the cases in the series; aggressive
rehabilitation was started promptly in all cases where this was possible. On average,
an additional 2.4 hr were required for the original procedure. This flap demands little
technical expertise for any microsurgical surgeon, and does not sacrifice any important
donor vessel. The flap should not be followed-up by conventional monitoring methods-,
instead, simple palpation of the pulse, Doppler auscultation, or PPG are required.
